Short Statue Flashcards
Ddx of Short Statue
BENIGN
1. Familial shortness
2. Constitutional delay
PATHOLOGICAL
(Proportional)
1. Emotional deprivation
2. IUGF - Chromosomal (Down’s, Turners), Congenital TORCH infections, Drugs, irradiation, IUGR (Russell Silver Syn)
3. Syndromes : Prada Wili Syndrome, Lawrence Moon Biedl Syndrome (MR, Retinitis pigmentosa, Polydactyly and hypogonadism)
3. Major illness without catch up growth - Malnutrition, IBDs, Heart/ Lung/ Renal disease, metabolic disease
4. Endocrine causes - Hypopituitarism, Hypothyroidism, Pseudohypoparathyroidism, Cushings syn, Growth hormone deficiency
(Disproportionate - skeletal dwarfism)
1. Truncal - TB spine, MPS (Type IV - Morquio’s syn)
2. Limb - Osteogenesis imperfecta (whole), Achondroplasia (proximal), Ellis Van Creveld Syndrome (distal)
3. Rickets
Examination steps in Short Statue
- Note shortness - confirm by measurement
- Note body proportions
Short limbs in skeletal dysplasia
Hemihypertrophy in Russel- Silver Syndrome - Note if Obese - Cushing’s / Hypopituitarism/ Pseudohypoparathyroidism
- Note any dysmorphic features (Cretin / Turner/ Pseudohypoparathyroidism)
- Systemic Exam
a. Features of rickets, pallor, cyanosis, wasting
b. Goitre, Webbed neck
c. UL- Short MCP, Wrist Swellings, Cubitus Valgus
d. LL - Bowing in Rickets
e. Chest - widely spaced nipples, Shield- like chest, Rickets rosary, Hyperinflation or deformity in chronic lung disease
f. CVS - murmurs
g. CNS - Visual field defects, fundi
h. Ask to measure BP
Normal Body Length
Newborn - 50 cm 6 month - 67 cm 1 year - 75 cm 2 year - 85 cm 3 year - 95 cm 4 year - 100 cm then 5.5 cm per year till puberty